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PubMed1994

Temporal bone dissection for display.

Increasing concern with medicolegal issues has heightened the need for surgical simulation in training. Familiarity with the surgical anatomy of the temporal bone is essential for effective and safe otological surgery. Refinement of surgical technique and intimate knowledge of temporal bone anatomy can be gained by accurate dissection. The products of such endeavours are both illustrative and instructive. The issues, methods and techniques necessary for display of anatomical dissections are discussed.

Connective Tissue↗

PubMed1993

Dural defects of the temporal bone.

Cerebrospinal fluid leakage (otorrhea or otorhinorrhea) from the temporal bone is the end result of rupture of the arachnoid membrane or herniation of the brain through a defect in the protective dura mater and calvarium. The rupture may be small, admitting only a herniation of arachnoid (meningocele), or be large enough to accommodate brain tissue (encephalocele). Flow of cerebrospinal fluid through either type of fistula may be a trickle or profuse, chronic or intermittent, and usually ceases temporarily for a few weeks following an attack of meningitis. The etiology, anatomy, signs and symptoms, and various methods of treatment for cerebrospinal fluid otorrhea and otorhinorrhea are discussed.

Brain Diseases↗

PubMed1990

Hyperbaric oxygen management of chronic staphylococcal osteomyelitis of the temporal bone.

Hyperbaric oxygen (HBO) has proven efficacious in the adjunct management of selected otolaryngologic problems: radiation therapy-induced osteoradionecrosis of the temporal bone, malignant external otitis, mandibular osteoradionecrosis and refractory osteomyelitis, soft tissue head and neck necrotizing fasciitis, compromised skin flaps and grafts, acute air or gas embolism, and otologic barotrauma. Herein is described the management of an insidious Staphylococcus aureus osteomyelitis of the temporal bone by pre- and postoperative HBO in conjunction with surgical debridement. The possible application of angiogenic agents and tetracycline bone-labeling in combination with hyperbaric oxygen therapy in the management of refractory neurotologic disease will be discussed.

Debridement↗

PubMed2001

Chondroblastoma of the temporal bone.

A rare case of chondroblastoma arising from the temporal bone that occurred in a 60-year-old woman is reported. The tumor appeared well demarcated and osteolytic on the radiographs. CT scan clearly depicted marginal and central calcification in the tumor. MR imaging demonstrated two components in the tumor: a solid component with predominantly low signal intensities on both T1- and T2-weighted sequences, and a multilocular cystic component with T1- and T2-elongation and fluid-fluid levels on the T2-weighted images. Postcontrast MR imaging revealed marked enhancement in the solid component and the septa of the cystic component.

Chondroblastoma↗

PubMed1984

Vestibular syndrome associated with temporohyoid joint fusion and temporal bone fracture in three horses.

Acute onset of vestibulocochlear and facial nerve dysfunction due to a stress fracture of the petrous part of the temporal bone was diagnosed in 3 horses. The fracture was secondary to chronic inflammatory changes in the petrous part of the temporal bone and the proximal stylohyoid bone, with fusion of the temporohyoid joint. Bacterial meningoencephalitis was a complicating factor. Treatment resulted in reduction of severity of clinical signs in 2 of the 3 cases, but residual compensated vestibular deficits persisted.

Animals↗

PubMed1988

Length of the styloid process of the temporal bone.

The length of 404 styloid processes of the temporal bone was measured on 246 macerated skulls from men and women aged between 26 and 93 years. The statistical distribution of the styloid processes in function of their length obviously shows the existence of two different groups. In the first one, the length is inferior or equal to 20 mm, while it is superior to this value in the second one. A length more than 30 mm that cannot be related with age is common (29%) despite its low clinical occurrence. To explain the existence of short and long styloid processes, a variable involvement of the different segments of the Reichert's cartilage during the morphogenesis is suggested.

Adult↗

PubMed1981

Sudden hearing loss associated with cochlear membrane rupture. Two human temporal bone reports.

Cochlear membrane ruptures occurred in the left temporal bones of two patients--one was a result of barotrauma caused by flying and was associated with sudden deafness, tinnitus, and some vertigo and the second occurred in a patient with profound deafness in a previously normal-hearing ear. Both occurred as ruptures of Reissner's membrane at the junction of the ductus reuniens with the cecum vestibulare portion of the cochlear duct. With healing, a balloon-like structure formed from the rupture site into the adjacent vestibule, resulting in a secondarily ruptured saccule duct in one case and in collapse of the saccule in the second case. Left-sided preponderance of such ruptures and the vulnerability of the ductus reuniens junction with the cochlea are described.

Aged↗

PubMed1995

Idiopathic perilymphatic fistulae: a temporal bone histopathological study. Clinical, surgical and histopathological correlations.

The temporal bone histopathological findings herein reported are the first to be from a patient who had, during life, the diagnosis of idiopathic perilymphatic fistulae. The patient received surgical treatment followed by rapid improvement of his vestibular symptoms. These specimens histopathologically demonstrate the patencies of the labyrinth capsule that were diagnosed (predicted) clinically during life, the qualities of the membranous labyrinth in both the operated and unoperated ears, and the elements of the surgical repair. Notably there is no evidence of endolymphatic hydrops. The diagnostic features which allowed this patient with fluctuating hearing loss, episodic vertigo, and tinnitus to be distinguished from a patient with Meniere's syndrome are discussed as are the implications regarding future and past studies of vestibular and cochlear disorders.

Aged↗

PubMed1993

Temporal bone dissection using a low cost miniature electric drill.

The performance of various specialized and general purpose drills was assessed for use in temporal bone dissection. The Minicraft MB 120 and MB 130 were found to be as effective as specialized drills but with greater convenience and much reduced cost. The use of these drills allows high quality temporal bone dissection to be performed on a limited budget.

Evaluation Studies as Topic↗

PubMed1989

Myxoid tumours in the temporal bone.

Myxoid tumours have the essential common feature, that they are difficult to remove radically because of their gelatinous consistency. Only one previous report describes a myxoid tumour--a myxoma--located to the temporal bone. This paper presents two such tumours in the temporal bone, a myxoma and an extraskeletal myxoid chondrosarcoma. The clinical and histological features of these tumours and the operative treatment are described and discussed.

Adult↗

PubMed2000

Giant cell reparative granuloma of the petrous temporal bone: a case report and literature review.

Giant cell reparative granuloma (GCRG) is an unusual, benign bone lesion that most commonly affects the maxilla and mandible; skull involvement is rare. The etiology is uncertain but may be related to trauma. GCRG is difficult to distinguish from giant cell tumor of the bone and has a lower recurrence rate. Thirteen reports of temporal bone GCRG in 11 patients have been reported. One report of a petrous GCRG in a 3-year-old girl has been identified. A 38-year-old male presented with a 2-year history of fullness in his left ear, ipsilateral hearing loss, and intermittent cacosmia. Computed tomography and magnetic resonance imaging revealed a large left-sided anterior temporal extradural mass. The patient underwent a left frontotemporal craniotomy and resection of a left temporal fossa tumor that involved the petrous and squamous parts of the temporal bone. The patient's post-operative course was uneventful, except for increased hearing loss secondary to opening of the epitympanum. Follow-up at one month revealed no other problems. Histopathology of the specimen was consistent with a giant cell reparative granuloma.

Case Reports↗

PubMed2001

Temporal bone histopathology in trisomy 22.

Trisomy 22 has multiple physical anomalies, and aural malformations are commonly associated with trisomy 22. However, there has been only one report describing the temporal bone histopathology in trisomy 22. Our case is the second reported temporal bone histopathology of trisomy 22. Aural anomalies in this case were less serious than those earlier described, though showing Mondini dysplasia of the bony and membranous labyrinth. Deafness in patients with trisomy 22 may manifest sensorineural, conductive or mixed hearing losses, and/or vestibular dysfunction of varying degrees, according to the site and severity of aural anomalies.

Abnormalities, Multiple↗

PubMed1995

[Immunohistochemical study on temporal bone of autopsy cases with Mycobacterium leprae infection].

Three temporal bones were obtained en bloc from autopsy cases with lepromatous leprosy from the middle cranial fossa side after removing the brain. After fixation with 10% formalin followed by sufficient decalcification, the specimens were embedded in paraffin en bloc and cut serially to stain every 10th section with hematoxylin and eosin (H&E) for anatomical orientation. An immunohistochemical study with anti-neurofilament, anti-MBP (myelin basic protein), anti-BCG (Bacillus Calmette-Gue'rin) and anti-PGL (Mycobacterium leprae-specific antiphenolic glycolipid-I) antibodies were performed to vestibular, cochlear and facial nerves, respectively, on the basis of anatomical orientation of the adjacent H&E sections. In one of three cases, positive staining by anti-PGL antibodies was recognized only in the facial nerve both in its internal auditory meatal and tympanic portions. However, even in this case, no neural damage was observed either by anti-neurofilament nor anti-MBP stainings. This finding supports the possibility of central neural infection by Mycobacterium leprae.

Aged↗

PubMed1997

[CT-assisted measurement of total and regional volumes of pneumatization in the temporal bone].

The total volume of air cells in the temporal bone and the regional volumes (tympanic cavity, petrous apex and mastoid antrum) were measured by using a system which we developed for the measurement of air cells by computerized digital processing of high-resolution CT images. We examined a total of 41 normal ears in 25 subjects ranging in age from 12 to 82 years (mean age 46.2). The total volume of pneumatization was approximately 4.05 +/- 1.59 ml and the volume of air cells in the tympanic cavity was 0.45 +/- 0.07 ml. Alveolation of the petrous apex was detected in 15 (36.6%) of the 41 ears, and the volume of air cells in the petrous apex was approximately 0.24 +/- 0.26 ml. The volume of air cells in the mastoid antrum was approximately 0.53 +/- 0.20 ml. The ears were divided into two groups, one with petrous alveolation (15 ears) and the other without it (26 ears). The ratios of regional pneumatization to total pneumatization were studied in the two groups. Statistically significant differences were found in the total volume and the volume of air cells in the mastoid antrum between the groups with and without petrous pneumatization (p < 0.05). The total volume of air cells did not correlate to the volumes of air cells in the tympanic cavity, mastoid cavity and petrous apex.

Adolescent↗

PubMed1976

[Radiologic aspects of temporal-bone fractures with facial paresis].

The value of the radiobiological diagnosis in establishing the localization of a facial palsy resulting from temporal bone fractures has been investigated in 49 cases. Radiological confirmation was found in 21 out of 37 cases of longitudinal fracture and in 11 out of 12 patients (90%) with a transverse fracture. The fracture line was seen by polytomography alone in 1 out of 21 (5%) longitudinal fractures and in 5 out of 11 (45%) transverse fractures. A precise readiological localization of the facial nerve lesion was only possible if the fracutre line was running across the long axis of the pyramid. The surgical revision of 37 patients has shown that the labyrinthine segment of the facial nerve was injured in 93% of longitudinal fractures and in 70% of the transverse fractures. Therefore, one should always be prepared to expose the labyringhine segment of the facial nerve when revising a facial nerve palsy due to a fracture of the temporal bone.

Adolescent↗

PubMed1980

Malignant neoplasms of the external auditory canal and temporal bone.

In a review of 136 patients with squamous cell, basal cell, and salivary gland cancers involving the external auditory canal and temporal bone, the majority of patients had received prior treatment and came to us with recurrent tumor. Squamous cell carcinoma of the concha and cartilaginous ear canal behaved aggressively. Five-year survival in 35 patients with deep temporal bone involvement was 29%. The major reason for failure in this group was incomplete resection of disease. Postoperative irradiation was of no benefit when the cancer could not be completely excised. When compared with surgery alone, combined therapy with postoperative irradiation did improve local control in patients with completely resected lesions but did not demonstrate a corresponding increase in five-year survival.

Adenoma, Pleomorphic↗

PubMed2003

Temporal bone abnormalities associated with hearing loss in Waardenburg syndrome.

OBJECTIVES/HYPOTHESIS: The objectives were to correlate audiometric thresholds with radiological findings and to determine the prevalence of inner ear radiological abnormalities in patients with hearing loss and Waardenburg syndrome. STUDY DESIGN: The study was a retrospective review of patients with Waardenburg syndrome identified in a pediatric hearing-impaired population and human genetics clinic. METHODS: Nine children with Waardenburg syndrome were identified. Eighty-nine children without sensorineural hearing loss served as control subjects. Clinical data, audiometric thresholds, and radiographic temporal bone measurements in these children were analyzed. RESULTS: Seven children were identified with hearing loss and Waardenburg syndrome. Four children had Waardenburg syndrome type 1, and three children had Waardenburg syndrome type 2. The overall prevalence of hearing loss in the total study population with Waardenburg syndrome was 78%. The mean pure-tone average was 99 dB. All of the children had sensorineural hearing loss. The hearing outcome was stable in 86% of the children. Twelve temporal bones were available for radiological analysis by computed tomography. Enlargement of the vestibular aqueduct was found in 50% of the CT scans. There was a significant difference in measurements of vestibular aqueduct width at the midpoint between the patients with Waardenburg syndrome and the control group (P <.05). There were also significant differences in the measurements of the vestibule (P =.0484), internal auditory canal (P =.0092), and modiolus (P =.0045) between the children with Waardenburg syndrome and the control group. CONCLUSION: A profound sensorineural hearing loss was characteristic of the study population with Waardenburg syndrome. Overall, 100% of patients with hearing loss and Waardenburg syndrome had temporal bone anomalies on at least one measurement of their inner ear, and 50% had an enlargement of the vestibular aqueduct at the midpoint. As shown by computed tomography, enlargement of the vestibular aqueduct and the upper vestibule, narrowing of the internal auditory canal porus, and hypoplasia of the modiolus are features of Waardenburg syndrome.

Audiometry, Pure-Tone↗

PubMed1983

Eosinophilic granuloma of the temporal bone: medical and surgical management in the pediatric patient.

Eosinophilic granuloma is frequently confused with infectious diseases or neoplastic conditions of the temporal bone. It is one of a spectrum of diseases classically known as histiocytosis X. Eosinophilic granuloma usually takes a benign clinical course; however, progression of disease has frequently been documented in the pediatric age group. Our interest in eosinophilic granuloma was generated by a 2-year-old white boy who presented with a large postauricular mass, aural discharge, and posterior-canal-wall granulation tissue. We present this patient's clinical course and a review of the literature concerning diagnosis, treatment, and prognosis of eosinophilic granuloma of the temporal bone.

Bone Diseases↗